Objective:To explore the category,prevalence and related factors of comorbidities associated with Tourette syndrome.Methods:125 patients with TS according to CCMD-3(Chinese Classification of Mental Disorders,3rd edition)were assessed with a self-designed family circumstance questionnaire,YGTSS,CBCL,Leyton obsessive-compulsive scale,and Conner's Child Behavior Checklist.Results:Of 125 TS patients,the comorbidities included attention deficit and hyperactivity disorder(ADHD,41.6%),obsessive-compulsive disorder(OCD,25.6%), anxiety disorders(8.0%),depressive disorders(4.8%),conduct disorders(8.0%),self-injurious behavior(3.2%),and sleep disorder(2.4%).Conclusion:There are many kinds of comorbid disorders at high prevalence in TS patients. These comorbidities adversely influence the therapy and prognosis of TS and are taken as the possible reasons for social function deficit.

OBJECTIVETo define the ideal time window for intubation after rocuronium administration during target-controlled infusion (TCI) ofpropofol and sulfentanil.

METHODSOne hundred and twenty elective surgical patients (age range 18-55 years) were randomized into 4 groups (n=30) according to the intubation time after administration of the muscle relaxant. Patients with predicted difficult airway were excluded. General anesthesia was induced by TCI of propofol and sulfentanil. A senior anesthesiologist blinded for the randomization performed the intubations at 1, 2, 3, or 4 min after injection of rocuronium, and the vocal card visibility was evaluated upon full exposure of the vocal cord and the intubation conditions assessed according to Cooper's score.

RESULTSThe intubation conditions were excellent or good in all patients, but the vocal cord visibility at 2-4 min differed significantly from that at 1 min after rocuronium administration (P<0.01). Suppression of the neuromuscular function 1 min after rocuronium administration differed significantly from that at other time points (P<0.01).

CONCLUSIONThe condition of vocal cord can be more suitable for intubation at 2-4 min than at 1 min after rocuronium administration as the ideal time window for intubation during TCI of propofol and sulfentanil.

Adolescent ; Adult ; Androstanols ; administration & dosage ; Anesthetics, Intravenous ; administration & dosage ; Humans ; Infusions, Intravenous ; Intubation ; methods ; Middle Aged ; Neuromuscular Nondepolarizing Agents ; administration & dosage ; Propofol ; administration & dosage ; Single-Blind Method ; Sufentanil ; administration & dosage ; Time Factors ; Vocal Cords ; drug effects ; Young Adult

BACKGROUNDWe undertook a randomized controlled trial to ascertain if single-incision laparoscopic cholecystectomy (SILC) was more beneficial for reducing postoperative pain than traditional laparoscopic cholecystectomy (TLC). Moreover, the influencing factors of SILC were analyzed.

METHODSA total of 552 patients with symptomatic gallstones or polyps were allocated randomly to undergo SILC (n = 138) or TLC (n = 414). Data on postoperative pain score, operative time, complications, procedure conversion, and hospital costs were collected. After a 6-month follow-up, all data were analyzed using the intention-to-treat principle.

RESULTSAmong SILC group, 4 (2.9%) cases required conversion to TLC. Mean operative time of SILC was significantly longer than that of TLC (58.97 ± 21.56 vs. 43.38 ± 19.02 min, P < 0.001). The two groups showed no significant differences in analgesic dose, duration of hospital stay, or cost. Median pain scores were similar between the two groups 7 days after surgery, but SILC-treated patients had a significantly lower median pain score 6 h after surgery (10-point scale: 3 [2, 4] vs. 4 [3, 5], P = 0.009). Importantly, subgroup analyses of operative time for SILC showed that a longer operative time was associated with greater prevalence of pain score >5 (≥100 min: 5/7 patients vs. <40 min, 3/16 patients, P = 0.015).

CONCLUSIONSThe primary benefit of SILC appears to be slightly less pain immediately after surgery. Surgeon training seems to be important because the shorter operative time for SILC may elicit less pain immediately after surgery.

Adolescent ; Adult ; Aged ; Cholecystectomy, Laparoscopic ; adverse effects ; Female ; Gallstones ; surgery ; Humans ; Male ; Middle Aged ; Operative Time ; Pain Measurement ; Pain, Postoperative ; diagnosis ; Polyps ; surgery ; Prospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo study the effect of endothelin-1 (ET-1) and its antagonists on the expression of endothelin and its receptors mRNA in HSC-T6 cells.

METHODSCultured HSC-T6 cells were randomly divided into 7 groups: Sham control group, ET-1 group (10 nmol/L ET-1), BQ-123 group [1 micromol/L BQ-123, a selective endothelin receptor A (ETRA) antagonist], BQ-788 group [1 micromol/L BQ-788, a selective endothelin receptor B (ETRB) antagonist], ET-1 + BQ123 group (10 nmol/L ET-1 + 1 micromol/L BQ-123), ET-1 + BQ-788 group (10 nmol/L ET-1 + 1 micromol/L BQ-788) and ET-1 + BQ-788 group (10 nmol/L ET-1 + 1 micromol/L BQ-123 + 1 micromol/L BQ-788). The expression of endothelin receptor mRNA of HSC-T6 cells was determined by reverse-transcription polymerase chain reaction (RT-PCR).

RESULTSThe expression of ETRA mRNA in ET-1 + BQ123 + BQ788 and ET-1 + BQ788 group was significantly lower than ET-1 group (0.329 +/- 0.044 and 0.292 +/- 0.023 vs. 0.440 +/- 0.030 P < 0.05). Compared with ET-1 group, the expression of ETRB mRNA in ET-1 + BQ788 group was down regulated obviously (0.499 +/- 0.136 vs. 0.153 +/- 0.071, P < 0.05). There was no significant difference in ET-1 + BQ123 group and ET-1 + BQ123 + BQ788 group when compared with ET-1 group (0.499 +/- 0.136 vs. 0.496 +/- 0.103 and 0.299 +/- 0.129, P > 0.05).

CONCLUSIONSET-1 has no obvious effect on the expression of ETRA mRNA in HSC-T6. ET-1 may up-regulate the expression of ETRB mRNA. Act on ETRA receptor, ET-1 can inhibit the expression of ETRB mRNA.

Animals ; Cells, Cultured ; Endothelin-1 ; pharmacology ; Gene Expression Regulation ; drug effects ; Hepatocytes ; drug effects ; metabolism ; Oligopeptides ; pharmacology ; Peptides, Cyclic ; pharmacology ; Piperidines ; pharmacology ; RNA, Messenger ; genetics ; Rats ; Rats, Sprague-Dawley ; Receptor, Endothelin A ; biosynthesis ; drug effects ; genetics ; Receptor, Endothelin B ; biosynthesis ; drug effects ; genetics

Haploinsuffieiency of the runt-related transcription factor 2 (Runx2) gene is widely known to be responsible for cleidocranial dysplasia (CCD).To date,more than 190 mutations in Runx2 gene have been reported to be related to CCD.In this study,a novel mutation of Runx2 gene was observed in a female with CCD.Genomic DNA was extracted from peripheral venous blood of the proband and eleven members of her family.Genetic testing on these twelve people identified a novel missense mutation (c.895T＞C,Y299H) in exon 5 of the RUNX2 gene in the proband.This mutation results in an amino acid change at codon 895 (P.Tyr 299 His.) from a tryptophan codon (TAT) to a histidine codon (CAT).Our finding may further extend the known mutation spectrum of the RUNX2 gene,and facilitate prenatal genetic diagnosis of CCD in the future.

Bias ; Humans ; Pain Measurement ; Pain, Postoperative

OBJECTIVETo probe into the mechanism of substance-partitioned moxibustion in treatment of primary dysmenorrhea (PD) of cold-damp stagnation type.

METHODSThe treatment group (105 cases of PD) were treated with substance-partitioned moxibustion and the control group (104 cases) were treated with Chinese drug Yueyue-shu. Their therapeutic effects were observed. Plasma beta-endorphin contents in menstrual period were determined before and after treatment in 40 patients of each group.

RESULTSThe total effective rate of 95.2% in the substance partitioned moxibustion group was better than 85.6% in the control group (P < 0.05); after treatment, plasma beta-endorphin content significantly increased in the substance-partitioned moxibustion group (P < 0.01).

CONCLUSIONSubstance-partitioned moxibustion has obvious therapeutic effect on primary dysmenorrhea of cold-damp stagnation type, which is carried out possibly through regulating the plasma beta-endorphin content as one of the mechanisms.

Adolescent ; Adult ; Cold Temperature ; Dysmenorrhea ; blood ; therapy ; Female ; Humans ; Menstrual Cycle ; Moxibustion ; Premenstrual Syndrome ; complications ; therapy ; Thermosensing ; beta-Endorphin ; blood

Objective To compare the safety and effectiveness of Propofol-Fentanyl and Propofol-Remifentanil total intravenous anesthesia for airway foreign body (FB) removal in children. Method 280 children aged 1 ~ 3 years underwent rigid bronchoscopy for FB removal were randomized into two groups. The Fentanyl group (Group F, n = 140) were given Propofol 2.00~3.00 mg/kg and Fentanyl 2.00 μg/kg for induction and Propofol 200.00 ~ 500.00 μg/(kg·min) for maintenance of anesthesia. The Remifentanil group (Group R, n = 140) were given Propofol 2.00 ~ 3.00 mg/kg and Remifentanil 1.00 ~ 1.50 μg/kg for induction of anesthesia, while anesthesia was maintained with Propofol 200.00 ~ 500.00 μg/(kg·min) and Remifentanil 0.10 ~ 0.20 μg/(kg·min). All the children during the procedure were with spontaneous respiration. SpO2 before inserting rigid bronchoscope (T1), 1 min (T2) and 3 min (T3) after insertion, 3 min (T4) and 10 min (T5) after extraction were recorded. PETCO2 after endoscopy (T6) was measured. Adverse events, including body movement, cough, breath-holding, and hypoxemia,were observed. The time of induction, surgery, recovery and the total dosage of the intravenous agents were recorded. Results SpO2 of the two groups were in normal range at T1 ~ 5, which was higher in group R than group F at T2 ~ 5 (P < 0.05). PETCO2 of group R was lower than group F at T6 (P < 0.05). The rate of body movement and cough were comparable between the two groups (P > 0.05), while breath-holding and hypoxemia were more frequent in group F (P < 0.05). The time of induction and recovery were shorter in group R (P < 0.05), while surgery time and the Propofol dosage were similar (P > 0.05). The total dose of Fentanyl was significantly higher than Remifentanil (P < 0.05). Conclusion Combination of Propofol with Fentanyl or Remifentanil both produce effective anesthesia in children undergoing FB removal. But Propofol-Remifentanil provides more stable oxygen saturation, faster induction and recurrence of anesthesia, as well as less intraoperative complications.

Animals ; Apoptosis ; Female ; Gene Transfer, Horizontal ; Genetic Therapy ; Hemorrhage ; pathology ; therapy ; Hepatocytes ; pathology ; Interleukin-10 ; genetics ; Male ; Pancreatitis, Acute Necrotizing ; pathology ; therapy ; Proto-Oncogene Proteins c-bcl-2 ; physiology ; Rats ; Rats, Wistar ; bcl-2-Associated X Protein

Adult ; Cholecystectomy, Laparoscopic ; methods ; Cholecystitis ; complications ; surgery ; Female ; Gallstones ; complications ; surgery ; Humans ; Treatment Outcome